National Core Indicators Program | NASDDDS & HSRI

NCI ANNUAL SUMMARY REPORT 2010 - 2011

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Cover Art: “Force of Nature” by Jennifer Walter

http://ykardell.zenfolio.com/jenniferwalter

http://www.theriotrocks.org/spotlight-studios

National Core Indicators (NCI), a joint venture between the National Association of State Directors of

Developmental Disabilities Services and the Human Services Research Institute, has been in

operation since 1997. Participating states utilize a common set of data collection protocols to gather

information about the performance of service delivery systems for people with intellectual and

developmental disabilities. Data from NCI are aggregated and used to support state efforts to

strengthen long term care policy, inform the conduct of quality assurance activities and compare

performance with national norms. NCI data additionally have been used as the basis of data briefs on

specific areas of interest such as employment, dual diagnosis, self-directed services, and autism

spectrum disorders.

On the national level, NCI data provide a rich source of information for researchers seeking answers

to important policy questions. Increasingly, these data sets are being requested for research

purposes, and several articles have been published in peer-reviewed journals in recent years.

As of June 2011, the NCI collaboration included 25 participating states and 4 sub-state entities. We

are pleased to launch the third NCI Annual Summary Report, which highlights activities and key

findings from 2010-2011.

Nancy Thaler Valerie J. Bradley Executive Director President National Association of State Directors Human Services Research Institute of Developmental Disabilities Services

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INTRODUCTION

National Core Indicators (NCI) began in 1997 as a collaborative effort between the National Association of State

Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI). The goal

of the program was to encourage and support NASDDDS member agencies to develop a standard set of performance

measures that could be used by states to manage quality and across states for making comparisons and setting

benchmarks. Fifteen states initially stepped forward to work on the Core Indicators Project, as it was originally known,

and pooled their resources to develop valid and reliable data

collection protocols. Over time, NCI has become an integral

component of over half the states’ quality management systems

and aligns with basic requirements for assuring quality in HCBS

Waivers. NCI states and project partners continue to work toward

the vision of utilizing NCI data not only to improve practice at the

state level but also to add knowledge to the field, to influence state

and national policy, and to inform strategic planning initiatives for

NASDDDS.

PARTICIPATING STATES

In 2010-2011, the membership of NCI included 25 states and two sub-state entities (see Figure 1).

FIGURE 1. PARTICIPATING NCI STATES 2010-11

NCI Vision:

Influence national and state policy

Improve practice at the state level

Add knowledge to the field

Inform the Association’s strategic

planning and priority setting

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CORE INDICATORS

The NCI framework includes approximately 100 performance and outcome indicators organized across five broad

domains: Individual Outcomes, Health Welfare & Rights, Staff Stability & Competency, Family Outcomes, and System

Performance. Each domain is broken down into sub-domains representing specific expectations. For example, “Work” is

a sub-domain of Individual Outcomes. Performance indicators for the

Work sub-domain assume that individuals receiving services have support

to find and maintain community integrated employment. The sub-

domains are measured by one or more performance indicators developed

by the steering committee of participating states. These performance

indicators were developed based upon a set of criteria including face

validity, usefulness as a benchmark, and feasibility to collect. Indicators

have remained largely consistent over the years. However, the indicators

were recently revised to include enhanced information about health,

wellness and employment.

Some indicators are measured using survey data gathered on a sample of

individuals, while others are computed using population data available

through state data systems (e.g., mortality reports). Survey tools are

regularly refined and tested for validity and reliability. The full list of core

indicators may be viewed and downloaded on the NCI website at

http://www.nationalcoreindicators.org.

This report highlights selected aggregate results from 2010-11. Detailed

summary reports of state by state results and national averages for all NCI measures are available on the website

nationalcoreindicators.org. The full reports are organized by data source.

2010-11 ACCOMPLISHMENTS, ACTIVITIES, AND ON-GOING EFFORTS

Through the years, the prominence of NCI has increased at the national and international level. With several

publications, international presentations, greater self-advocate involvement, and the new NCI website, NCI has

continued to enhance its outreach in 2010-11. Further, in 2011, the Administration on Intellectual and Developmental

Disabilities (AIDD) awarded NASDDDS a five year contract to expand NCI. Through the contract, funding is being made

available to up to five new states each year with the goal of increasing NCI participation to all 50 states and the District

of Columbia by 2016.

Two grants from the National Institute on Disability and Rehabilitation Research (NIDRR), which supported case studies

on how NCI is implemented at the state level, wrapped up in 2011. Between 2009 and 2011, HSRI staff visited Missouri,

New York, Orange County, California, Texas, and Washington to meet with state NCI project leads and state directors of

developmental disabilities agencies and staff. HSRI also conducted focus groups with interviewers and shadowed NCI

interviews. The site visits yielded information about the use of NCI data for HCBS waiver assurances, quality assurance

and management, and to track performance over time. Results have been used to enhance NCI through increased

technical assistance, provision of examples of states’ use of NCI data, and revisions of training and guidance materials. A

recently published guidebook for using NCI data, Using National Core Indicators (NCI) Data for Quality Improvement

Initiatives, can be found on the NCI website under the Resources tab.

Domains and Sub-domains addressed in this report

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During the past year, California, Florida, and Georgia conducted feedback surveys of respondents to the Adult Consumer

Survey. These studies were designed to assess, among other things, whether the interviewers systematically provided

necessary information to the individuals being interviewed. For example, the study evaluated whether the interviewer

informed the respondent that the survey was optional, and whether the respondent chose where and when the survey

was conducted. The results of the surveys were largely positive. Nearly all respondents indicated that interviewers were

respectful, that they were asked where and when they would like the meeting to be held, and the majority of

respondents were told that their participation was optional. Additional questions from the Florida and Georgia feedback

surveys found that most interviewers explained what the survey was about and let interviewees know that they didn’t

have to answer all the questions if they didn’t want to. The results of these studies were also used to test survey validity.

In collaboration with research partners from the University of Minnesota and the University of Sydney Australia, NCI

program staff produced a number of publications that were accepted by several leading journals including “Overweight

and Obesity Among Adults with Intellectual Disabilities Who Use ID/DD Services in 20 U.S. States,” published in the

American Journal on Intellectual and Developmental Disabilities (November 2011). NCI data were also used as the

foundation for data briefs produced by NCI project staff -- 2010-11 data briefs included: “Living at Home with Families,”

“Self-Direction,” “Autism,” and “Dual Diagnosis.” Quarterly webinars are held for all participating states to provide NCI

updates, give states a forum to discuss the ways in which they are using NCI data, and to address any questions or

concerns they may have.

As part of NCI’s commitment to improving the ease and validity of data collection, the online data entry system

application (ODESA) was again enhanced for the 2010-11 data cycle to include more user-friendly and administrative

functions. The ODESA now houses the Adult Consumer Survey along with all three Family Surveys within the same site

and will be shifting to a new, larger platform in 2011-12 to accommodate to the increase in usage. Upgrades include:

logic checks, ability to view past edits to data entries, and a report generator to view survey progress. A technical survey

was sent to NCI state operational staff to determine how best to continue efforts to facilitate states in the data

collection process. The survey found that several states are beginning to administer the Adult Consumer Survey using a

laptop or other electronic device – interviewers enter data in the ODESA during the survey meeting. Based on the

results, on-going efforts and discussion will include creating a more user-friendly look for ODESA and helping states to

pre-populate background information.

NCI program staff met with members of California’s Consumer Advisory Committee (CAC) in 2010 and again in 2011 to

create a user-friendly version of the Consumer Outcome Report. The CAC was instrumental in helping to develop this

new way of disseminating NCI data. The first national user-friendly report, “What We Have Learned from the NCI Adult

Consumer Survey”, is complete and is posted on the NCI website. It features 20 indicators with outcomes described in

plain language and accompanying pie charts. In subsequent years each state will also receive a user-friendly report with

their state data.

DATA SOURCES

Four primary data sources are referenced in this report. The Adult Consumer Survey gathers information face-to-face

from service recipients and their families or other representatives. States are expected to interview a random sample of

at least 400 individuals. Additionally, three Family Surveys are administered by mail. The Family Surveys collect data on

family and guardian perspectives of the quality of services and supports received by adults living at home, adults living

outside the home, and children living at home. For each Family Survey, states typically send out 1,000 to 1,200 surveys

in order to obtain a target return of 400 responses per survey. Figure 2 below provides a brief description of the target

population for each survey, the method of administration, the total number of states that used each tool in 2010-11,

and the total number of surveys collected overall.

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FIGURE 2. SUMMARY OF SURVEYS BY STATE 2010-2011

NCI Survey Target Population Method of

Administration

# of

States

2010-11

Total # of

Surveys

Adult Consumer

Survey

Adults 18 and older receiving at

least one service besides case

management

In-person interview 15 8,796

Adult Family

Survey

Families of adults 18 and older

living at home

Mail 9 3,654

Family Guardian

Survey

Families or guardians of adults

18 and older living outside the

home

Mail 11 3,482

Child Family

Survey

Families of children under 18

(or under 23 if still in school

system) living at home

Mail 7 1,886

Links to full reports

Detailed reports on Adult Consumer and Family Survey outcomes by state with national average comparisons are

available on the NCI website: http://www.nationalcoreindicators.org. These reports are organized by data source and by

year. Additional Data Briefs and other special reports focusing on special topics are also posted on the Reports page:

http://www.nationalcoreindicators.org/resources/reports/.

ANALYSIS

NCI data management and analysis is coordinated by Human Services Research Institute (HSRI). Most states entered

data in ODESA which HSRI in turn downloaded for analysis. Data files were reviewed for completeness and compliance

with standard NCI formats, and then cleaned and merged with invalid responses eliminated. For the purposes of this

report, data were analyzed with no risk-adjustment. This is the first year significance testing was conducted on Family

Surveys.

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SELECTED RESULTS 2010-2011

FAMILY OUTCOMES

In 2010-2011, nine states collected a total of 3,654 Adult Family Surveys (AFS),11 states collected a total of 3,482

Family/Guardian Surveys (FGS),and seven states collected a total of 1,886 Child Family Surveys (CFS). Responses to all

three Family Surveys are based on either a 5-point Likert scale (always, usually, sometimes, seldom, or never) or

dichotomous yes or no responses.

Selected characteristics

For all three Family Surveys, a higher percentage of respondents indicated their family member receiving services was

male – 57% AFS and FGS and 64% CFS. On average, individuals for whom the FGS was completed were a decade older

than those for the AFS (45 years old compared to 34). The average age of family members from the CFS was 10. For all

three Family Surveys, the majority of family members receiving services were white (68% AFS, 80% FGS, and 65% CFS) or

black (18% AFS, 12% FGS, and 15% CFS).

Other Disabilities

For all surveys, the most common type of disability was an intellectual disability. However this was true at far higher

rates for AFS (77%) and FGS (82 %) compared to 37% of CFS respondents. Conversely, nearly twice as many

respondents from the CFS reported the child was on the Autism Spectrum (37%) as compared to those from the AFS

(18%) and FGS (16%).

FIGURE 3. TYPE OF DISABILITY BY FAMILY SURVEY

Income Levels

Household income tended to be similar among surveys with most respondents falling within a range at or below

$25,001-$50,000 per year.

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FIGURE 4. HOUSEHOLD BY FAMILY SURVEY

Out-of-Pocket Expenses

Just over half of FGS respondents did not spend any out-of-pocket money on services or supports for their family in the

past year (52%), while over half the respondents from the AFS and CFS spent between $101-$1000 or $1001-$10,000.

FIGURE 5. OUT-OF-POCKET EXPENSE IN THE PAST YEAR BY FAMILY SURVEY

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Information and Planning

As shown in Figure 6, below, a higher percentage of respondents from the FGS

always received enough information to help plan their family member’s supports

and services, and the information is always easy to understand.

FIGURE 6. FAMILY RECEIVES INFORMATION ABOUT SUPPORTS AND SERVICES

The majority of respondents from all surveys reported that they assisted in creating their family member’s service plan.

This occurred with slightly more frequency for respondents from the CFS (93%) than those from the AFS (86%) and FGS

(76%) (see Figure 7). Results show more than half the family members for both the AFS and FGS helped make their own

service plan (58% and 62%).

FIGURE 7.FAMILY HELPS MAKE SERVICE PLAN BY FAMILY SURVEY

Nearly all respondents indicated the service plan includes things that are important to the family – 93% AFS, 94% FGS,

and 92% CFS.

Family member’s case

manager/service coordinator

who helps plan services and

support is always

knowledgeable:

58% AFS, 66% FGS, and 57%

CFS

Family member’s case

manager/service coordinator

who helps plan services and

support is always courteous:

79% AFS, 80% FGS, and 77%

CFS

Family receives information

about their family member’s

rights:

91% AFS, 92% FGS, 89% CFS

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Access and Support Delivery

The majority of respondents from all Family Surveys reported they were

always able to get in contact with their support workers and case

manager/service coordinator when needed (58% and 56% AFS, 54% and 59%

CFS). As illustrated in Figure 8, below, about half of the respondents for all

surveys indicated there was consistency in support worker staffing. Likewise,

around half the respondents for each survey felt that support workers had the

proper training to meet the needs of their family member.

FIGURE 8.CONSISTENCY AND TRAINING OF SUPPORT WORKERS BY FAMILY SURVEY

Of those whose adult family member transitioned from school to state DD funded services in the past year, 64% of

respondents from the AFS reported that they were happy with this transition. 84% of FGS respondents answered

similarly. Though over half the respondents indicated their family member gets all the services listed in the service plan,

less than half reported that services and supports change when their family member’s needs change (shown in Figure

9). The data show that 47% of AFS and 45% of CFS respondents reported their family member always got the services

and supports needed. However, 41% of AFS respondents and 44% of CFS respondents indicated that their family

member needs other services that are not currently offered. This is a particular concern since being responsive to

changed needs is one of the sub-assurances that CMS looks for as part of waiver compliance.

FIGURE 9.ACCESS TO NEEDED SERVICES BY FAMILY SURVEY

Family member always has

access to needed equipment:

53% AFS, 69% FGS, and 41% CFS

Family member has access to

health services:

97% AFS and CFS

Services with the lowest rates of

access:

respite services – 75% AFS and

79% CFS

mental health services – 84%

AFS and 83% CFS

dental services — 80% AFS and

93%

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Choice and Control

Results from the Choice and Control section show that, compared with past years, a greater proportion of respondents

have control over who works with family members. Furthermore, an even greater percentage desire that control.

Shown in Figure 10, about half of AFS and CFS respondents had control over the management and hiring support

workers. Additionally, most family respondents wanted to assert such control.

FIGURE 10.CONTROL OVER HIRING AND MANAGEMENT OF SUPPORT WORKERS BY FAMILY SURVEY

Slightly higher proportions of respondents from the AFS knew the amount of money spent by ID/DD agencies for the

care of their family members, as compared to CFS respondents (32% and 20%). Just 12% of AFS and 11% of FGS

respondents reported that their family member knew how much money was spent by the ID/DD agency on their behalf.

However, AFS respondents reported at a much higher rate that their family member has some input on how the money

is spent (86% AFS) than FGS respondents (27% FGS) (Figure11, below).

FIGURE 11.CONTROL OVER HIRING AND MANAGEMENT OF SUPPORT WORKERS BY FAMILY SURVEY

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Community Connections

A low percentage of respondents reported that they always receive adequate support to keep their family member

connected to the community. Only 23% AFS, 39% FGS, and 20% CFS respondents reported that case managers/service

coordinators or staff always help family member use typical community supports (e.g., church or recreational centers)

(Figure12). Similarly, a minority indicated family and friends are always helped by case managers/service coordinators

and staff to assist with providing support to their family member (26% AFS, 42% FGS, and 27% CFS).

FIGURE 12. CASE MANAGER/SERVICE COORDINATOR OR STAFF CONNECT FAMILY TO COMMUNITY SUPPORTS BY FAMILY SURVEY

As indicated in Figure 13, the majority of respondents for all surveys reported their family member participates in

community activities – 71% AFS, 81% FGS, and 60% CFS.

FIGURE 13.FAMILY MEMBER PARTICIPATES IN COMMUNITY ACTIVITIES BY FAMILY SURVEY

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Satisfaction

Less than half the respondents from each survey were always satisfied with their family member’s services and supports

– 41% AFS, 49% FGS, and 40% CFS (Figure 14, below).

FIGURE 14.SATISFACTION BY FAMILY SURVEY

As shown in Figure 15 below, most respondents knew how to file complaints or grievances about provider agencies or

staff (62% AFS, 71% FGS, and 54% CFS), and the majority of respondents were satisfied with the way complaints and

grievances are handled (82% AFS, 79% FGS, and 76% CFS). Nearly all respondents also knew how to report abuse or

neglect (80% AFS, 78% FGS, and 74% CFS). Of those who filed a report of abuse or neglect in the past year, the majority

found the appropriate parties responsive to their report (71% AFS, 81% FGS, and 79% CFS).

FIGURE 15.KNOW HOW TO FILE COMPLAINT AND ABUSE AND NEGLECT REPORTS

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Outcomes

Nearly all respondents felt services and supports made a positive difference for their family member – 96% AFS,

97%FGS, and 94% CFS. Most also indicated their family member’s supports and services match those in their service plan

(92% AFS, 95% FGS, and 92% CFS, Figure 16).

FIGURE 16.SERVICES MATCH GOALS IN SERVICE PLAN

Illustrated in Figure 17 below, less than a third of respondents from each survey reported that their family member’s

services or supports were reduced, suspended, or terminated in the past year (31% AFS, 22% FGS, and 34% CFS). Of the

respondents whose family member had a reduction in services or supports in the past year, nearly two-thirds of

respondents from each survey indicated the reduction affected their family member (67% AFS, 61% FGS, and 63%

CFS).

FIGURE 17. SERVICE OR SUPPORT REDUCTION

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SELECTED RESULTS 2010-2011

INDIVIDUAL OUTCOMES

Sample characteristics

In 2010-2011, a total of 8,796 Consumer Surveys were completed in 15 states.

Disabilities

Only 14% of all people surveyed did not have some type of disability in addition to ID/DD (Figure 18). The most common

co-occurring disabilities were mental illness or psychiatric diagnosis (33%), seizure disorder (26%), or another disability

not listed (23%).

FIGURE 18. PROPORTION OF PEOPLE WITH OTHER DISABILITIES

Residence

As is shown in Figure 19, the majority of people surveyed were living either in a community-based residence (which

includes group home and agency-operated apartment-type setting, (32%) or with parent or relatives (31%).

FIGURE 19. PROPORTION OF PEOPLE LIVING IN FOUR MAJOR TYPES OF RESIDENCE

Self-Direction

Only 6% of people were identified as using a self-directed supports option.

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Employment

In 2010-2011, 16% of people had a job in the community; the average hourly wage in community jobs was $7.11. Twenty-four percent (24%) of people living in their own home or apartment , 15% living in community-based residences and 14% living with a parent or relative had a job (Figure 20). Only 21% of people with a job who were surveyed received benefits (vacation and/or sick leave) at their community jobs. FIGURE 20. EMPLOYMENT STATUS BY LIVING ARRANGEMENT

Of people surveyed, the four most common types of community jobs in which people were employed were: cleaning

and maintenance (29%), food preparation (20%), retail (17%), and assembly and manufacturing (5%).

System Performance

Access

A large majority of people reported that their staff have adequate training (92%)

and get them needed services (83%). Of those who reported they did not get

needed services, the most common needs were: finding or changing jobs (24%),

social and/or relationship areas (21%), and transportation (20%) (Figure 21).

FIGURE 21. SERVICES NEEDED

Gets Needed Services by

Residence:

Parent/Relatives Home: 74%

Independent Home/Apt: 82%

Community-Based Residence:

87%

Institution: 92%

Hourly Wage by Residence:

Parent/Relatives Home: $8.21

Independent Home/Apt:

$6.71

Community-Based Residence:

$6.54

Institution: $6.31

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Choice and Decision-Making

Many respondents reported that they did not have input in major life decisions such as where and with whom they live

and where they go during the day. As illustrated in Figure 22, only 50% chose their home, and 45% chose their

roommates. Though 80% had input into where they work, only 60% had input into where they go during the day (their

non-work day activity). Furthermore, just 60% had input into choosing their work staff and 58% their day activity staff.

Sixty-four percent (64%) chose their home staff, and 41% percent of persons surveyed did not choose his/her case

manager.

FIGURE 22. PROPORTION OF PEOPLE WHO HAD INPUT INTO MAJOR LIFE CHOICES

A higher proportion of people reported having input into every day decisions such as choosing their own schedule (85%),

how to spend free time (93%), and how to spend their money (89%) (Figure 23).

FIGURE 23. PROPORTION OF PEOPLE WHO HAVE INPUT INTO EVERYDAY DECISIONS

Results by residence type show that people living in institutions were least likely to have input, particularly in life

decisions areas. Those living in their own apartments or homes were most likely to exercise choice. These findings are

consistent with results from previous years and discussed in the 2010 NCI Data Brief, People Who Live at Home.

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Health Care and Health

Only 5% of people surveyed were in poor health and just 8% used tobacco products.

Most people surveyed had routine care -- 97% had a primary care doctor and 92%

had had a physical exam in the past year. However, the proportion of people who

received other routine preventive health care was lower (Figure 24). Eighty percent

(80%) had a dental visit in the past year, 61% had a hearing exam in the past five

years, and 59% received an eye exam in the past year. Seventy-five percent (75%)

received a flu vaccination in the past year and only 39% had ever had a pneumonia

vaccine. Seventy-nine percent (79%) of women over 40 had a mammogram in the

last two years, and 71% of all women had a Pap test in the past three years. Fifty-six

percent (56%) of men over 50 had a PSA test in the past year, and only 19% of

people over 50 had had a colorectal cancer screening in the past year.

FIGURE 24. PROPORTION OF PEOPLE WHO RECEIVED PREVENTIVE HEALTH CARE SERVICES

Rates of preventive health care services varied by where people resided. For almost all services, people living with

parents or relatives and those living in independent homes or apartments were less likely to have received services

than people living in community-based residences and in institutions.

Rates of receiving

preventive health care

services varied by residence

Dental exam: 70% in

independent homes and

family homes compared to

over 95% of people in

institutions and 88% in

community-based

residences

Vision exam: with family

and 58% in independent

homes compared to 70% of

those in institutions and

community-based

residences

Pneumonia vaccine: 74% in

institutions compared to

33% of in independent

homes and 28% living with

family

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HOW STATES ARE USING NCI

NCI states use data in a number of ways to inform their quality management processes and to improve the delivery of

services and supports to people with intellectual and other developmental disabilities. Many states use their NCI data

to:

Complete CMS waiver requirements

Increase quality assurance/improvement

Make state by state comparisons

Assist with community transition

Provide information for planning to Developmental Disabilities Councils and Quality Councils

Specific examples of states’ use of NCI data include:

Alabama’s Division of Developmental Disabilities uses the overall satisfaction number and employment numbers

in their SMART Plan which is a budgeting and planning process through the Governor’s office to gauge their

success in meeting national benchmarks. The State is conducting a pre/post survey analysis of people leaving

Alabama’s last developmental center. An Alabama Summary is forwarded to providers and they are encouraged

to use findings to include in their own agency Quality Plans.

Washington’s Developmental Disabilities Council convened a review panel of self-advocates, family members,

community providers and other professionals to review the results of the NCI survey data. As a result of their

work, the review panel made recommendations to the Division.

For more examples of how states are using NCI data, visit the NCI website (http://www.nationalcoreindicators.org).

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NCI DIRECTORS AND STATE CONTACTS

The members of the NASDDDS Research Committee provide oversight and

direction to NCI, and the liaisons in each state coordinate project activities

and implementation at the state level.

NASDDDS Research Committee

NADDDS Members

Bernard Simons (MO)

John Martin (OH)

Lee Price (VA)

Linda Rolfe (WA)

Alex Bartolic (MN)

Stephen R. Hall, Ph.D (KY)

Non-NASDDDS Members

Amy Hewitt (RTC/ICI/UMN)

Rick Hemp (CICG/UC)

Bill Kiernan (ICI/UMass)

Val Bradley (HSRI)

NASDDDS Staff

Chas Moseley

Nancy Thaler

2010-11 State Coordinators

Alabama Jeff Williams

Arizona Sherri Wince

Arkansas Cindy Young

California Renee Kurjiaka

Florida Edwin B. DeBardeleben

Georgia Eddie Towson

Hawaii Aaron Arakaki

Illinois Michael Hurt

Kentucky Betsy Dunnigan

Louisiana Dena Vogel

Maine Karen Glew

Massachusetts Janet George

Missouri Margy Mangini

New Hampshire Karen Kimball

New Jersey Catherine Yankitis

New Mexico Marc Kolman

New York Ray Pierce

North Carolina Maria Fernandez

Ohio Tina Evans

Ohio- MEORC Tara Nicodemus

Ohio- Clearwater COG Julie Cupp

Oklahoma Genny Gordon

Pennsylvania Jeanne Parisi

South Dakota Kelli Anderson

Texas Janie Eubanks

Washington State Lisa Weber

NASDDDS http://www.nasddds.org http://www.hsri.org

NCI PROGRAM STAFF: Chas Moseley Co-Project Director NASDDDS cmoseley@nasddds.org Mary Lee Fay

Director of National Core

Indicators

mlfay@nasddds.org

Val Bradley Co-Project Director HSRI vbradley@hsri.org Sarah Taub Project Manager staub@hsri.org Josh Engler Project Coordinator jengler@hsri.org Julie Bershadsky Research Associate jbershadsky@hsri.org Stephanie Giordano Research Analyst sgiordano@hsri.org Cheryl Sartori Project Assistant csartori@hsri.org

Dorothy Hiersteiner Research Analyst dhiersteiner@hsri.org

http://www.nationalcoreindicators.org